Healthcare Provider Details

I. General information

NPI: 1144367384
Provider Name (Legal Business Name): MENTAL HEALTH PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 TATE BLVD SE SUITE 529
HICKORY NC
28602-1433
US

IV. Provider business mailing address

1985 TATE BLVD SE SUITE 529
HICKORY NC
28602-1433
US

V. Phone/Fax

Practice location:
  • Phone: 828-327-2595
  • Fax: 828-325-9826
Mailing address:
  • Phone: 828-327-2595
  • Fax: 828-325-9826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier3404912
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer
# 2
Identifier3408153
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer
# 3
Identifier5902046
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer
# 4
Identifier6005549
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: MR. JOHN M HARDY
Title or Position: AREA DIRECTOR
Credential:
Phone: 828-327-2595